Provider Demographics
NPI:1841365665
Name:HATTWICK, EMILY A (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:HATTWICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:ORTHOPAEDIC SURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-4063
Mailing Address - Fax:202-476-4613
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:ORTHOPAEDIC SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-4063
Practice Address - Fax:202-476-4613
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237267174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
I24123Medicare UPIN
015932M37Medicare PIN